Less than 7% of U.S. adults are in good cardiometabolic shape, and new research warns the trend is only getting worse.
Cardiometabolic health is an umbrella term that includes blood pressure, blood sugar, blood cholesterol, weight and/or the presence of heart disease.
"While we know that cardiometabolic health among Americans is a significant problem, we were surprised by the magnitude of the crisis," said study author Meghan O'Hearn, a doctoral candidate at the Friedman School of Nutrition Science and Policy at Tufts University in Boston. "The lack of good health and well-being across the board is truly devastating and has only been getting worse."
Researchers found the steepest declines in percentage of Americans with healthy weights and blood sugar (glucose) levels.
In 1999, 1 in 3 adults maintained a normal weight, compared to 1 in 4 by 2018. Six in 10 adults were free of prediabetes or diabetes in 1999, compared to fewer than 4 in 10 in 2018, the study showed. People with prediabetes have higher-than-normal blood sugar levels, but don't yet have full-blown diabetes.
Americans are also less active these days and more sedentary, another likely contributor to the trends, O'Hearn said.
For the study, researchers looked at measures of cardiometabolic health among 55,000 adults who participated in a national health and nutrition survey between 1999 and 2018.
They found significant differences by sex, age, race, ethnicity and education in the presence of good cardiometabolic health factors.
Adults with less education were half as likely to have optimal health when compared to adults with more education. Additionally, the percentage of adults with good cardiometabolic health declined among Hispanic folks, non-Hispanic Black people, and adults of other races, while showing only a modest uptick among white people.
"Social determinants of health, such as food and nutrition security, social and community context, economic stability and structural racism may put individuals of different education levels, races and ethnicities at an increased risk of health issues," O'Hearn said.
Turning these trends around won't be easy, she said, but it is possible. It would mean enhancing U.S. domestic food aid programs and providing agricultural subsidies and incentives, she said.
"More patient and consumer education on achieving a healthy diet could also help, as could working with the food and health care industries on innovative solutions," O'Hearn said.
The need is urgent, she added.
"If we don't address this dire and worsening cardiometabolic health crisis, we will see increased disease burden, increased health care spending, and greater disparities across the U.S. population," she said.
The study will be published in the July 12 issue of the Journal of the American College of Cardiology.
Marion Nestle, a retired professor of nutrition, food studies, and public health at New York University, reviewed the findings.
"The news here is how bad the trend is," she said.
"Both obesity and type 2 diabetes are risk factors for cardiovascular disease," Nestle added. "This paper provides more evidence for the need to get serious about obesity prevention."
The American Heart Association provides tips on how to lose weight and keep it off.
SOURCES: Meghan O'Hearn, MS, doctoral candidate, Friedman School of Nutrition Science and Policy, Tufts University, Boston; Marion Nestle, PhD, MPH, professor emerita, nutrition, food studies and public health, New York University, New York City; Journal of the American College of Cardiology, July 12, 2022